1.Current HIV/AIDS Knowledge, Perceptions and Practices among the General Population in Kandy, Sri Lanka: Program Implications
Koji KANDA ; Yoshihide OBAYASHI ; Ananda JAYASINGHE ; K. Tudor SILVA ; Romeo B. LEE ; Hiko TAMASHIRO
Journal of International Health 2010;25(1):11-19
Introduction
Recent strategic plans for HIV/AIDS control in Sri Lanka have stressed the need to focus prevention interventions on most-at-risk populations and similarly laid out the importance of improving HIV/AIDS awareness among the general population. Programmatic attention has to be strengthened to effectively change AIDS-related poor knowledge, low risk perceptions and risky sexual practices at the individual level, and avert an epidemic. While current data on at-risk populations are available to inform interventions, there is paucity of latest evidence for the general population programs.
Methods
In April-May 2009, a cross-sectional study involving 1,239 population-based and randomly selected respondents aged 15-49 was completed in Kandy, Sri Lanka (response rate=87.2%). The study collected data on HIV/AIDS knowledge, perceptions and sexual practices among the general population to supply current information for the intervention. Data were analyzed using univariate, bivariate and multivariate approaches.
Results
While almost all respondents were aware of HIV/AIDS, sizeable proportions (44.7-76.2%) knew little about the types of sexually transmitted infections, and about the transmission modes and prevention methods of HIV/AIDS. Although 80% of respondents had low risk perceptions and were mostly at low risk behaviorally, their knowledge of HIV/AIDS was inadequate. They assessed their risks and practiced unsafer sex without the benefit of having evidence-based knowledge. The knowledge, perceptions and practices were significantly associated with gender, marital status, education, religion, and/or residence.
Conclusions
The gaps in substantive knowledge on HIV/AIDS suggest that no effective information and other related types of support have been provided to the general population in Sri Lanka. In the context of the need to contribute to sustaining the low prevalence of HIV in the country, a base of scientific knowledge and wider advocacy programs should be developed.
2.Community-based Evaluation of Health-seeking Behavior of People with Animal Bite Injuries in a District of Sri Lanka
Gino C. MATIBAG ; Rossana A. DITANGCO ; Taro KAMIGAKI ; Thula G. WIJEWARDANA ; Pallegoda V. R. KUMARASIRI ; Anil W. KALUPAHANA ; D. R. Anuruddhika DISSANAYAKE ; D. D. Niranjala De SILVA ; G. S. Panduka De S. GUNAWARDENA ; Yoshihide OBAYASHI ; Koji KANDA ; Hiko TAMASHIRO
Journal of International Health 2008;23(3):173-179
Introduction
Of the 55,000 deaths per year due to rabies, 56% occur in Asia and 44% in Africa. Despite the existence of the national rabies control program in Sri Lanka, rabies is still prevalent, suggesting that animal bite victims may have failed to observe the proper first aid measures and seek immediate medical treatment. The purpose of this study is to describe the health-seeking behavior among animal bite victims of a selected population in Kandy District, Sri Lanka. The influences of subjects’ demographic characteristics to these behaviors were studied.
Methods
We conducted face-to-face interviews in May 2006 among households with family members having history of animal bite injuries. Data on health-seeking behaviors such as first aid measure application, immediate medical consultation, and completion of post-exposure prophylaxis (PEP) were obtained. The association between behaviors and demographic characteristics were evaluated using Chi-square test or the Fisher’s exact test.
Results
Of the 6968 sample population, 357 (5.1%) had history of animal bites one year prior to the survey. Most of the subjects performed first aid measures (n=297, 83.2%) and sought medical treatment (n=319, 89.4%) within 24 hours (n=295, 82.6%) of the injury. Only 9.8% (n=35) of the subjects completed the PEP. There was no association between health-seeking behavior and demographic characteristics. Two subjects died having symptoms that resembled rabies without completing the necessary PEP, and two animal specimens were sent for laboratory testing that confirmed one case of feline rabies one year prior to the study.
Conclusion
In general, the health-seeking behaviors of the subjects were not influenced by their demographic characteristics which may contribute to greater difficulties in controlling rabies. To strengthen the rabies control program, effective education of both the public and health sectors by thorough and adequate wound washing, and strict adherence with the recommended treatment schedule is of paramount importance.
3.Knowledge, attitudes, and practices survey of rabies in a community in Sri Lanka.
Gino C MATIBAG ; Taro KAMIGAKI ; Pallegoda V R KUMARASIRI ; Thula G WIJEWARDANA ; Anil W KALUPAHANA ; D R Anuruddhika DISSANAYAKE ; D D Niranjala De SILVA ; G S Panduka De S GUNAWARDENA ; Yoshihide OBAYASHI ; Koji KANDA ; Hiko TAMASHIRO
Environmental Health and Preventive Medicine 2007;12(2):84-89
OBJECTIVESThe primary objective of this study was to determine the level of knowledge, attitudes and practices (KAP) of rabies management and control of a sample population. The secondary objective was to compare the KAP with respect to rabies management and control between urban and rural areas and between pet and non-pet owners.
METHODSThis cross-sectional study was carried out by conducting face-to-face interviews using structured questionnaires among 1570 respondents from selected households in the Kandy District, Sri Landa.
RESULTSApproximately 58% of the sample population was pet owners. Among all the respondents, there was a high level of awareness (90%) that dogs are the most common rabies reservoir, that the disease is fatal (79%), and that rabies can be prevented by vaccination (88%). Most of the subjects (96%) would seek treatment from a doctor or a hospital after being bitten by a dog. Although 76% of the respondents said that their pet dogs were vaccinated, only one-half were able to present a vaccination certificate upon request. The subjects from the urban areas would submit the head of an animal for rabies evaluation (69%) compared with those from the rural areas (57%). Pet owners (93%) are more aware that dog rabies vaccines are available from authorized offices than non-pet owners (87%).
CONCLUSIONSThe level of awareness of rabies and the level of receptiveness to rabies control measures are high. There is a difference in the attitudes and pet care practices relevant to rabies control between urban and rural areas. Pet owners tend to be more cooperative to rabies control activities. The attitudes and practices of the respondents may reflect the inaccessibility of facilities and the lack of services that would enable community participation in rabies control.